title: Skin thickness on bony prominences measured by ultrasonography in patients with spinal cord injury.
abstract: OBJECTIVE
  The detailed assessment of soft tissues over bony prominences and identification of methods of predicting pressure sores would improve the quality of care for patients with spinal cord injury (SCI). Comparing skin thicknesses on bony prominences in patients with SCI to those in healthy individuals will represent, to our knowledge, the first study aimed at determining whether differences in skin thicknesses between these groups can be detected by ultrasound.
  
  
  METHODS
  In both patients and controls, skin thicknesses on the sites at risk for pressure ulcers - sacrum, greater trochanter, and ischium - were evaluated using high-frequency ultrasound. The waist was also evaluated by the same method for control as it was considered to be a pressure-free region.
  
  
  METHODS
  Thirty-two patients with complete thoracic SCI and 34 able-bodied individuals.
  
  
  RESULTS
  The skin was significantly thinner over the sacrum and ischial tuberosity in individuals with SCI compared with healthy individuals. No significant differences were observed in skin thicknesses over the greater trochanter or the waist between the two groups.
  
  
  CONCLUSIONS
  Protecting skin integrity in patients with paraplegia is challenging due to many contributing factors, such as prolonged pressure, frictional/shearing forces, and poor nutrition. Thinning of the skin can increase the risk of soft tissue damage, leading to pressure ulcers. The significant differences in skin thickness at the sacrum and ischium provide the basis for establishing the early signs of pressure damage. Measuring skin thickness by ultrasound is a reliable non-invasive method that could be a promising tool for predicting pressure ulcers.
authors.affiliation: Ankara Physical Medicine & Rehabilitation Training and Research Hospital of the Ministry of Health, Ankara, Turkey. elifyalcin78@gmail.com
authors.forename: Elif
authors.initials: E
authors.lastname: Yalcin
authors.forename: Mufit
authors.initials: M
authors.lastname: Akyuz
authors.forename: Burcu
authors.initials: B
authors.lastname: Onder
authors.forename: Halil
authors.initials: H
authors.lastname: Unalan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Degirmenci
mesh_terms: D000328:Adult; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D007512:Ischium / Q000000981:diagnostic imaging; D008297:Male; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control; D012447:Sacrum / Q000000981:diagnostic imaging; D012867:Skin / Q000000981:diagnostic imaging*; D013119:Spinal Cord Injuries / Q000150:complications*; D014463:Ultrasonography